Sage Orthopaedics

Accumulating case reports have described tendon rupture in men who use anabolic-androgenic steroids (AAS). However, no controlled study has assessed the history of tendon rupture in a large cohort of AAS users and comparison nonusers.  AAS abusers, compared with otherwise similar bodybuilders, showed a markedly increased risk of tendon ruptures, particularly upper-body tendon rupture.     Click here to read the article.  

Five articles from the October 2015 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full. The featured articles for this month are  “Novel Application of Magnetic Resonance Imaging Demonstrates Characteristic Differences in Vasculature at Predilection Sites of Osteochondritis Dissecans,” “Why Do Osteochondral Allografts Survive?: Comparative Analysis of Cartilage Biochemical Properties Unveils a Molecular Basis for Durability,” “Autograft Versus Allograft Anterior Cruciate Ligament Reconstruction: A Prospective, Randomized Clinical Study With a Minimum 10-Year Follow-up,” “Deficits in Glenohumeral Passive Range of Motion Increase Risk of Shoulder Injury in Professional Baseball Pitchers: A Prospective Study,” an

Articular reconstruction is recommended for some unstable capitellar osteochondritis dissecans (OCD) lesions. Capitellar osteochondral autograft transplantation (OAT) through an open approach for optimal visualization and perpendicular graft implantation has been advocated. However, arthroscopic capitellar OAT may achieve the same treatment goals with decreased morbidity and ability to treat the entire joint for pathologic changes.   To read the article, click here.

Multiple techniques have been suggested for the treatment of isolated knee articular cartilage injuries. For smaller lesions (

Five articles from the September 2015 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full. The featured articles for this month are “Factors Associated With Failure of Nonoperative Treatment in Lateral Epicondylitis,” “Select Injury-Related Variables Are Affected by Stride Length and Foot Strike Style During Running,” “The Effect of Diabetes, Hyperlipidemia, and Statins on the Development of Rotator Cuff Disease: A Nationwide, 11-Year, Longitudinal, Population-Based Follow-up Study,” “Relationship Between Quadriceps Strength and Patellofemoral Joint Chondral Lesions After Anterior Cruciate Ligament Reconstruction,” and “Effects of Acetabular Rim Trimming on Hip Joint Contact Pressures: How Much Is Too Much?”

Excessive physiological anterior and rotational knee laxity is thought to be a risk factor for noncontact anterior cruciate ligament (ACL) injuries and inferior reconstruction outcomes, but no thresholds have been established to identify patients with increased laxity. The healthy contralateral knees of patients with noncontact ACL injuries display different laxity values both for internal rotation and anterior displacement compared with healthy control knees. The identification of knee laxity profiles may be of relevance for primary and secondary prevention programs of noncontact ACL injuries.    Click here to read the article.

Five articles from the August 2015 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full. The featured articles for this month are "Head, Face, and Eye Injuries in Collegiate Women's Field Hockey," "Evaluation of Sexual Function Before and After Hip Arthroscopic Surgery for Symptomatic Femoroacetabular Impingement," "Comparison of Arthroscopic Microfracture for Osteochondral Lesions of the Talus With and Without Subchondral Cyst," "A Qualitative Invesitgation of Return to Sport After Arthroscopic Bankart Repair: Beyond Stability," and "High Incidence of Infrasinatus Muscle Atrophy in Elite Professional Female Tennis Players."

Recent publications have described significant variability in the femoral attachment and overall anatomy of the anterolateral ligament (ALL). Additionally, there is a paucity of data describing its structural properties. Defined ALL attachment locations can be reproducibly identified with intraoperative landmarks or radiographs. The biomechanical analysis suggests that most traditional soft tissue grafts are sufficient for ALL reconstruction.   Click here to read the article.

Five articles from the July 2015 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full. The featured articles for this month are “Platelet-Rich Plasma Intra-articular Knee Injections Show No Superiority Versus Viscosupplementation: A Randomized Controlled Trial," "'Critical' Bone Loss in Shoulder Instability Functional Outcomes Worsen With 'Subcritical’’ Bone Loss,'" "Tension Band Plating for Chronic Anterior Tibial Stress Fractures in High-Performance Athletes," "Prevalence of Ulnar Collateral Ligament Surgery in Professional Baseball Players," and "Outcome of a Combined Anterior Cruciate Ligament and Anterolateral Ligament Reconstruction Technique With a Minimum 2-Year Follow-up."

While the preparticipation evaluation (PPE) is widely used by medical practitioners, its overall effectiveness is unknown, in part because there are no standardized or centralized mechanisms to collect and analyze medical historyinformation. While some data in this population are self-evident, we were not aware of the high frequency of past injuries, the magnitude of time lost from sport, the high frequency of past surgery, and the number of participants still symptomatic from injuries. The ePPE is a valuable tool for collecting and analyzing aggregate injury and illness data in athletes, such as the finding that 11% of injuries that were reported were unresolved and still symptomatic.   Click here to read the article.

Five articles from the June 2015 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full. The featured articles for this month are "The Effect of Trochlear Dysplasia on Patellofemoral Biomechanics: A Cadaveric Study With Simulated Trochlear Deformities," "A Comparative Study on the Biomechanical and Histological Properties of Bone-to-Bone, Bone-to-Tendon, and Tendon-to-Tendon Healing: An Achilles Tendon–Calcaneus Model in Goats," "The Effect of a Combined Glenoid and Hill-Sachs Defect on Glenohumeral Stability: A Biomechanical Cadaveric Study Using 3-Dimensional Modeling of 142 Patients," "Platelet-Rich Plasma Increases Anti-inflammatory Markers in a Human Coculture Model for Osteoarthritis," and "Shoulder Function

Distal biceps brachii tendon repairs performed with a tension slide technique using a cortical button (CB) and interference screw are stronger than those based on suture fixation through bone tunnels (BTs) in biomechanical studies. However, clinical comparison of these 2 techniques is lacking in the literature. Both the single-incision CB and double-incision BT techniques provided excellent clinical results. Complications were more common in the single-incision CB group and most commonly involved paresthesias of the superficial radial nerve.   Click here to read the article.

Five articles from the May 2015 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full. The featured articles for this month are “Association of Equipment Worn and Concussion Injury Rates in National Collegiate Athletic Association Football Practices: 2004-2005 to 2008-2009 Academic Years,” “Prevalence of and Risk Factors for Dislocation Arthropathy Radiological Long-term Outcome of Arthroscopic Bankart Repair in 100 Shoulders at an Average 13-Year Follow-up,” “No Association Between Fibrosis on Magnetic Resonance Imaging at Return to Play and Hamstring Reinjury Risk,” “Relationship Between Knee Mechanics and Time Since Injury in ACL-Deficient Knees Without Signs of Osteoarthritis,” and “Tibial and Femoral Tunnel

The tibial tubercle–trochlear groove (TT-TG) distance and trochlear structure have become important radiographic measurements in the evaluation and management of patients with patellar instability. Many orthopaedic surgeons, however, do not have access to musculoskeletal radiologists and therefore must make such measurements independently. The results of this study suggest that the intra- and interobserver reliability in the MRI measurement of the TT-TG distance and TDI is high for both orthopaedic surgeons and musculoskeletal radiologists. In addition, the TT-TG distance may be lower than previously thought in patients with patellar instability.   Click here to read the article.

Five articles from the April 2015 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full. The featured articles for this month are “Sports-Specialized Intensive Training and the Risk of Injury in Young Athletes: A Clinical Case-Control Study,” “The Prevalence and Combined Prevalences of Anatomic Factors Associated With Recurrent Patellar Dislocation: A Magnetic Resonance Imaging Study,” “Association Between Ball-Handling Versus Defending Actions and Acute Noncontact Lower Extremity Injuries in High School Basketball and Soccer,” “Does Obesity Affect Outcomes in Hip Arthroscopy?: A Matched-Pair Controlled Study With Minimum 2-Year Follow-up,” and “On-Site Treatment of Exertional Heat Stroke.”  

Recent prospective randomized trials support primary plate fixation of displaced midshaft clavicle fractures. However, the safety and efficacy of this practice have not been well documented in athletes, nor has the time to return-to-sport. The Latarjet procedure can provide satisfactory outcomes, including a low recurrence rate and reliable functional recovery. Defects at the anteroinferior glenoid were restored to nearly normal after coracoid transfer by use of the Latarjet procedure, which is an anatomically matched reconstruction.   Click here to read the article.

Five articles from the March 2015 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full. The featured articles for this month are “MRI Volume and Signal Intensity of ACL Graft Predict Clinical, Functional, and Patient-Oriented Outcome Measures After ACL Reconstruction,” “Surgical Management of Osteochondritis Dissecans Lesions of the Patella and Trochlea in the Pediatric and Adolescent Population,” “Structural Properties of the Intact Proximal Hamstring Origin and Evaluation of Varying Avulsion Repair Techniques: An In Vitro Biomechanical Analysis,” “Anterior Cruciate Ligament Reconstruction With Contralateral Autogenous Patellar Tendon Graft: Evaluation of Donor Site Strength and Subjective Results,” and “Revisi

Five articles from the February 2015 issue summarized in five minutes, with the addition of a brief editorial commentary. The 5-in-5 feature is designed to give readers an overview of articles that may pique their interest and encourage more detailed reading. It may also be used by busy readers who would prefer a brief audio summary in order to select the articles they want to read in full. The featured articles for this month are "The Impact of Previous Hamstring Strain Injury on the Change in Eccentric Hamstring Strength During Pre-Season Training in Elite Australian Footballers," "The Effect of Donor Age on the Structural and Mechanical Properties of Allograft Tendons," Femoral Nerve Blockade is Associated with Persistent Strength Deficits at Six Months Post ACL Reconstuction in Pediatric and Adolescent Patients," "Factors Affecting Capsular Volume Changes and Association with Outcomes after Bankart Repair and Capsular Shift," and "Correlation of Meniscal and Articular Cartilage Injuries in Children and Ad

Rotator cuff tears are common, and rotator cuff repair represents a major health care expense. While patients often benefit from rotator cuff repair, anatomic failure of the repair is not unusual. In spite of a dramatic increase in the number of publications per year, there is little evidence that the results of rotator cuff repair are improving. The information needed to guide the management of this commonly treated and costly condition is seriously deficient. To accumulate the evidence necessary to inform practice, future clinical studies on the outcome of rotator cuff repair must report important data relating to each patient’s condition, the surgical technique, the outcome in terms of integrity, and the change in patient self-assessed comfort and function.   Click here to read the article.

There has been an increase in minimally invasive surgery for chronic exertional compartment syndrome (CECS), despite the potential for incomplete compartment release and iatrogenic injuries. To our knowledge, no study has examined the effect of the length of fascial release on compartment pressures. This study demonstrates a strong correlation between fasciotomy length and a reduction in intracompartmental pressures in a swine model. Our study suggests that 90% fascial release may represent a possible watershed zone, returning the intracompartmental pressure to a value at or near baseline values.    Click here to read the article.